Charles a Jacobson MD

NPI #1144376617 in Moscow, Idaho

Provider Information

NPI Number: 1144376617
Entity Type: Organization
Organization Name: Charles a Jacobson MD
Primary Specialty: Orthopaedic Surgery
Enumeration Date: Jan 26, 2007
Last Updated: Aug 19, 2014

Practice Location

Address: 2500 W A ST
Address 2: SUITE 201
City: Moscow
State: Idaho
ZIP Code: 83843-6000
Phone: (208) 883-2828

Authorized Official

Name: CHARLES A JACOBSON, M.D.
Title: OWNER
Phone: (208) 883-2828

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Orthopaedic Surgery	207X00000X	Primary

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